On 20 August, Dr Christopher Lane and colleagues published a paper in Lancet Neurology showing that hypertension in midlife (40-65 years of age) was associated with the development of brain pathology in later years. Previous studies have shown that elevated blood pressure or hypertension in middle age is linked to an increase in Alzheimer’s disease (AD) risk. However, the specific changes in the brain that occur as a result of midlife hypertension have yet to be fully investigated. To address this question, researchers turned to the neuroscience substudy of Insight 46, an ongoing longitudinal cohort study of people born within one week of each other in 1946. Insight 46 has collected detailed health information from participants at regular intervals since birth, including blood pressure measurements and measures of cognitive function.
Aiming to focus on late-life dementia risk, researchers studied a group of 502 dementia-free Insight 46 participants. Detailed MRI imaging and neuropsychological assessments were performed, evaluating brain amyloid accumulation, white matter hyperintensity (a marker of disease) and cognitive function. Decreases in brain volume and increases in white matter hyperintensity volume were observed in participants who were hypertensive in midlife – although no cognitive changes were found. Of particular interest was the observation that midlife hypertension did not seem to affect late-life amyloid status, indicating that amyloid may not play an important role in increasing AD risk associated with early hypertension. Together, these results suggest that blood pressure management early on may help maximise brain health in later life.
https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(19)30228-5/fulltext
